Published November 27th, 2020
What is a Near Miss Report Form?
A near-miss form or near-miss report form is used to document detailed statements of near miss events which could have resulted in injury or property damage. It is used by safety officers to record the details of near miss events so that risks can be mitigated and more serious, even fatal, incidents can be prevented.
A good near miss report should be easily understood and comprehensive. Every detail counts, so that proper action can be taken to prevent injuries and accidents in the future. This will help ensure a safer environment for your workers and the public. Your near miss form should cover the following:
- Date and time of the near miss event
- Location of the incident
- Details about the incident such as hazards, objects, and threats involved
- People involved, including affected persons and witnesses
Near Miss Reporting Example
Near miss reporting is essential in every industry, especially those that put workers at risk of accidents. It raises organizational awareness about the threats, hazards, and risks that an employee faces and should deal with.
An employee used a ladder to get up on the roof and fix a leak. Upon reaching the 4th step/rung, his foot slips, but he manages to regain his balance and no accident occurred.
Following submission of a near miss report, the ladder was inspected and it was found that a step grip was missing. This was immediately rectified, preventing other employees from getting into a similar accident or near miss incident.
Technology to Streamline Near Miss Reporting
Near misses can occur daily in all industries, but they are not always reported and sometimes considered too trivial. Paper-based near miss report forms also take longer to fill out and the submitted paper near miss forms tend to get lost, making pen and paper an impractical solution.
Risks are often time-sensitive and taking proper action on near miss report findings can prevent incidents from recurring and causing more serious problems.
iAuditor is a powerful mobile app that allows easy paperless near miss reporting with photos as evidence to better describe incidents for future preventive measures. Electronic done on the iAuditor app can be submitted and shared faster, with intended recipients receiving notifications via the app itself, email, or SMS. Preview a sample near miss report here.
How do you Write a Near Miss Report with iAuditor?
Below are guide steps on how you can use iAuditor allows your teams to report near misses easily without compromising quality of data gathered:
- Using your mobile or tablet device, start filling up your near miss report by indicating crucial details to the report such as:
- Date and time of the near miss event
- Name of the employee filling up the report
- Provide the location of the near miss by either typing in the complete address or pinning it on the map.
- Provide the fundamental details of the incident by stating the hazards, objects, threats, and people involved or affected.
- Support your report with photo evidence to better explain the situation.
- Lastly, complete with a signature for validation. A comprehensive report will then be automatically generated, ready for you to share with team members and others.
To get you started, we’ve provided 3 easy-to-use digital near miss templates below. Download and use them for free anytime, anywhere with the iAuditor mobile app.
3 Featured Near Miss Report Templates
Near Miss Report Form
This near miss report template is used to document near miss incidents to mitigate the risk and prevent recurrence. It is used by safety teams to perform the following:
- Record the date and time of the near miss event;
- Document the details of the incident including location, equipment used, and people involved;
- Capture photos and attach a detailed description of the root causes of the incident;
- Add overall recommendations; and
- Sign off with a digital signature to validate the near miss report.
Quick Near Miss Form
Use this near miss form to quickly record the incident and indicate if work stopped or continued business as usual. Generate web reports that you can easily share to intended recipients.
Near Miss Template
This near miss template allows providing the description and photos surrounding the incident as well as inclusion of the names of other witnesses of the near miss.